Upper-Extremity Peripheral Nerve Injuries

Abstract

Good outcomes after median and radial nerve repairs are attributable to the following factors: the median nerve's innervation of proximal, large finger, and thumb flexors; and the radial nerve's similar innervation of proximal muscles that do not perform delicate movements. This is contrary to the ulnar nerve's major nerve supply to the distal fine intrinsic hand muscles, which require more extensive innervation. The radial nerve also has a motor fiber predominance, reducing cross-motor/sensory reinnervation, and radial nerve-innervated muscles perform similar functions, decreasing the chance of innervation of muscles with opposite functions.

Factors predicting sensory and motor recovery after the repair of upper limb peripheral nerve injuries

“…Of these, 126 were selected for review of the full text after primary screening, and 67 were judged to meet the criteria for inclusion in the present study[78910111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364656667686970717273]. …”

“…In the present study, median and ulnar nerve sensory recovery had ORs for good to excellent sensory recovery of 0.44 and 0.36, respectively, compared with radial nerve sensory recovery; and the ulnar nerve had an OR for good to excellent motor recovery of 0.30 compared with radial nerve motor recovery. Murovic et al[68] reported that the rates of good to excellent results after the repair of radial, median, and ulnar nerve injuries were 86%, 75%, and 56%, respectively. Ruijs et al[4] reported that the rate of motor recovery was 71% lower after the repair of ulnar nerve injuries than median nerve injuries.…”

“…In extensive crush injuries, there may be a significant area of damaged tissue, resulting in poor local perfusion after the debridement of dead tissue. Murovic[68] studied 1,837 patients with upper extremity nerve injuries and found that the rate of good to excellent results after knife injuries was 91% after the repair of median and radial nerve injuries, and 73% after the repair of ulnar nerve injuries. Secer et al[86] studied 455 patients with gunshot or shrapnel injuries to the ulnar nerve and found that the rate of good to excellent results was < 32%.…”

Radial nerve transection associated with closed humeral shaft fractures: a report of two cases and review of the literature

“…Proponents of the 2-stage approach argue that the extent of nerve damage and the resultant zone of injury cannot be declared at the initial stage. 8,9 During the delayed reconstruction, injured nerve tissue can be precisely identified and resected, followed by graft interposition. In the acute setting, this distinction between healthy and injured nerve is not possible, and therefore damaged nerve may be left behind, which could consequently jeopardize a satisfactory outcome.…”

Cervical and Upper Limb Peripheral Nerve Injuries in Adults: Electrodiagnostic Studies and Symptoms

“…The most affected nerves in the upper limb are ulnar, median, radial, and digital nerves (7)(8)(9). Mild injuries may cure without intervention, however, severe injuries may lead to lifelong disabilities if they are not diagnosed and treated appropriately (2,3,10,11).…”